Multidrug resistance (MDR) mediated by MDR1 (ABCB1) P-glycoprotein and related ATP-binding cassette (ABC) transporters is an impediment to successful cancer therapy. ABCB5 P-glycoprotein is a novel ABC transporter, which mediates drug efflux in cancer cells and regulates cell fusion and resultant differentiation of progenitor cells in physiological tissues. It is hypothesized that ABCB5 mediates dual functions in cancer, conferring MDR via its function as a drug efflux transporter, and regulating tumor renewal as a determinant of cell fusion involving tumor stem cells. This study aims to (1) identify systematically ABCB5 drug efflux substrates and examine the role of ABCB5 in the chemoresistance to such compounds, (2) determine whether ABCBS-expressing cancer cells function as tumor stem cells, and (3) investigate the role of ABCB5 in cancer MDR and tumor formation in vivo and examine whether ABCB5 can be specifically targeted for tumor eradication. First, ABCB5 gene and protein expression will be assayed across the NCI-60 cancer cell lines with resistance profiles for >100,000 compounds and drug resistance correlations will be established by. COMPARE analysis. Candidate ABCB5 transport substrates will be validated experimentally using competitive drug efflux analysis in ABCB5 gene-transfected cell lines, and chemosensitivity assays performed in ABCBS-blocked human cancer cell lines and murine ABCB5 -/- knockout cells. Second, the capacity of ABCBS-positive tumor cells vis-a-vis ABCBS-negative tumor bulk populations for self-renewal and the mechanistic contribution of ABCBS-positive progenitor cells to tumor culture growth and differentiation will be examined in vitro using tumor clonogenicity and cell fusion assays. Third, the in vivo role of ABCB5 in chemoresistance to identified drug substrates and the in vivo relevance of ABCBS-positive tumor cells for tumor formation and growth will be studied in human to mouse tumor xenograft models. The results will define the role of ABCB5 in cancer MDR and will establish whether chemoresistant ABCBS- positive cells function as tumor stem cells in expressing cancers. Thus, the findings will identify whether ABCB5 represents a novel therapeutic target in clinical oncology.